Joint use of location and acceleration data reveals influences on transitions among habitats in wintering birds.

Quantifying relationships between animal behavior and habitat use is essential to understanding animal decision-making. High-resolution location and acceleration data allows unprecedented insights into animal movement and behavior. These data types allow researchers to study the complex linkages between behavioral plasticity and habitat distribution. We used a novel Markov model in a Bayesian framework to quantify the influence of behavioral state frequencies and environmental variables on transitions among landcover types through joint use of location and tri-axial accelerometer data. Data were collected from 56 greater white-fronted geese (Anser albifrons frontalis) across seven ecologically distinct winter regions over two years in midcontinent North America. We showed that goose decision-making varied across landcover types, ecoregions, and abiotic conditions, and was influenced by behavior. We found that time spent in specific behaviors explained variation in the probability of transitioning among habitats, revealing unique behavioral responses from geese among different habitats. Combining GPS and acceleration data allowed unique study of potential influences of an ongoing large-scale range shift in the wintering distribution of a migratory bird across midcontinent North America. We anticipate that behavioral adaptations among variable landscapes is a likely mechanism explaining goose use of highly variable ecosystems during winter in ways which optimize their persistence.

Shoulder-specific Outcome after Proximal Humerus Fracture Influences Medium-term Overall Quality of Life. / Das schulterspezifische Outcome nach proximaler Humerusfraktur hat Einfluss auf die mittelfristige allgemeine Lebensqualität.

BACKGROUND: Surgical treatment of proximal humerus fracture is an established procedure. Postoperative complications have been shown to have a significant impact on shoulder-specific outcome. Little is known to date about an influence on injury-independent quality of life. AIM OF THE WORK: The aim of this retrospective study is to analyse whether patients with a poor functional outcome after surgically treated proximal humerus fracture also show a reduced general quality of life in the medium term. Emphasis is placed on the analysis of patients with poor functional outcome due to postsurgical complications. MATERIAL AND METHODS: Evaluation of all patients operated at one level 1 trauma centre with a proximal humerus fracture in the period 01.01.2005 to 31.12.2015 and follow-up using validated scores (Constant-Murley Score [CMS], EQ-5D). Two groups, group A with good outcome (∆CMS ≤ 15P.) and group B with poor outcome (∆CMS ≥ 16P.), were defined. Furthermore, descriptive variables including definition of a complication were defined in advance. RESULTS: 138 patients were included in the study (group A: 91, group B: 47). The mean follow-up was 93.86 months ± 37.33 (36-167). Group B had significantly more complications. Furthermore, patients with poor outcome regarding the shoulder (group B) were also found to have significantly lower EQ-VAS (78.9 ± 19.2 [20.0-100] vs. 70.4 ± 19.5 [15.0-98.0]; p = 0.008) and EQ index (0.91 ± 0.14 [0.19-1.00] vs. 0.82 ± 0.17 [0.18-1.00]; p < 0.001). DISCUSSION: In conclusion, in the present study, the patients with poor outcome of shoulder function in CMS have significantly lower overall quality of life after a mean of more than 6 years of follow-up. The poor outcome was due to a significantly higher postoperative complication rate. This was independent of the fracture morphology present and the surgical procedure used.

Updated estimates of large and medium vessel strokes, mechanical thrombectomy trends, and future projections indicate a relative flattening of the growth curve but highlight opportunities for expanding endovascular stroke care.

BACKGROUND: A study was undertaken to determine the incidence of acute ischemic stroke (AIS) and strokes related to large (LVO) and medium (MVO) vessel occlusions, and to estimate annual mechanical thrombectomy (MT) volume, past trends and future growth. METHODS: A population-based analysis was performed to estimate the rate of AIS, LVOs (internal carotid artery terminus, M1 branch of the middle cerebral artery, basilar artery) and MVOs (M2 and M3 branches of the middle cerebral artery, anterior and posterior cerebral arteries). MT estimates were determined from multiple governmental data sources. Annual US numbers were adjusted for population growth. RESULTS: The incidence of AIS is estimated at 216 (95% CI 199 to 238)/100 000 persons/year or 718 191 (95% CI 661 483 to 791 121) AIS/year in the USA. A vascular occlusion was observed in 21% of patients with AIS (95% CI 15 to 29). The rate of LVO was 24/100 000 persons/year (95% CI 19 to 31) or 80 075 (95% CI 62 457 to 104 375) LVOs/year, and the rate of MVO was 20/100 000 persons/year or 65 798 (95% CI 45 555 to 95 110) MVOs/year. MT estimates for 2021 are 39 164 procedures with a flattening of the growth curve from 2019 (9%, 2020-2021; 4%, 2019-2020) as opposed to initial steep growth from 2015 to 2018. Current MT procedures represent 5% of all AIS, 27% of all vascular occlusions (LVO+MVO) and 38% of all LVO and M2 occlusions. The current trajectory indicates a future growth of 5-10%/year for the next several years. CONCLUSION: A decline in MT growth is observed. The incidence of LVO+MVO is estimated at 44/100 000 persons/year or almost 144 000 large and medium vessel strokes annually. Of these, currently an estimated 27% undergo an MT procedure, indicating an opportunity for growth. Further expansion may require focusing on the elderly, medium vessel strokes and workflow efficiencies from diagnosis to treatment.

Comorbidities, substance abuse, weight and age are independent risk factors for postoperative complications following operation for proximal humerus fractures: a retrospective analysis of 1109 patients.

INTRODUCTION: This study aimed to investigate the influence of epidemiologic parameters on complications that needed operative revision of operatively treated proximal humerus fractures. METHODS: We performed a retrospective single-center study in a level 1 trauma center. We included all patients with operatively treated proximal humerus fractures from January 1 2005 to December 31 2015. We characterized our cohort and subgroup using descriptive statistics. The primary outcome was postoperative complications. For this purpose, postoperative complications were defined in advance, an operative revision was necessary on a general rule. The secondary outcome was a model of the risk factors for complications created with multiple logistic regression. RESULTS: We included 1109 patients. The average age was 67.2 years (± 16.4), and 71.4% of the fractures occurred in women. A total of 644 patients (58.1%) had between one to three comorbidities, and 27.8% had four or more. The fracture morphology was as follows: 3 part 41.8%, 4 part 26.9%, 2 part 24.3%, and dislocation fracture 6.7%. Complications occurred in 150 patients (13.5%). The number of comorbidities [odds ratio (OR) 2.85, p < 0.01], body weight (OR 1.15, p = 0.02), and substance abuse (OR 1.82, p = 0.04) significantly correlated with the risk of complications. We achieved a sensitivity of 48% and a specificity of 74% for the variables body weight, substance abuse, age, and comorbidities CONCLUSION: The epidemiologic parameters, comorbidities, substance abuse, weight, and age are independent risk factors for complications. If these factors are present, one can predict a postoperative complication requiring surgical revision with low sensitivity and moderate specificity. Therefore, concerning the high number of multi-morbid patients with proximal humerus fractures, an increased postoperative complication rate can be expected. LEVEL OF EVIDENCE: Level of evidence IV.

Influenza A Viruses in Whistling Ducks (Subfamily Dendrocygninae).

As compared to other Anseriformes, data related to influenza A virus (IAV) detection and isolation, and IAV antibody detection in whistling ducks (Dendrocygna spp. and Thalassornis leuconotus; subfamily Dendrocygninae) are limited. To better evaluate the potential role of whistling ducks in the epidemiology of IAV, we (1) conducted surveillance for IAV from black-bellied whistling ducks (BBWD, Dendrocygnaautumnalis) sampled in coastal Louisiana, USA, during February 2018 and 2019, and (2) reviewed the published literature and Influenza Resource Database (IRD) that reported results of IAV surveillance of whistling ducks. In the prospective study, from 166 BBWD sampled, one H10N7 IAV was isolated (0.6% prevalence), and overall blocking enzyme-linked immunosorbent assay (bELISA) antibody seroprevalence was 10%. The literature review included publications and data in the IRD from 1984 to 2020 that reported results from nearly 5000 collected samples. For any given collection, the IAV isolation rate never exceeded 5.5%, and seroprevalence estimates ranged from 0 to 42%. Results from our prospective study in Louisiana are consistent with this historic literature; however, although all data consistently demonstrated a low prevalence of infection, the potential role of this species in the epidemiology of IAV should not be totally discounted. In sum, whistling ducks can be infected with IAV, they represent important species on many areas where waterfowl winter, and their distribution across the globe appears to be changing.

Winter fidelity, movements, and energy expenditure of Midcontinent Greater White-fronted Geese.

BACKGROUND: Animal movement patterns are the result of both environmental and physiological effects, and the rates of movement and energy expenditure of given movement strategies are influenced by the physical environment an animal inhabits. Greater white-fronted geese in North America winter in ecologically distinct regions and have undergone a large-scale shift in wintering distribution over the past 20 years. White-fronts continue to winter in historical wintering areas in addition to contemporary areas, but the rates of movement among regions, and energetic consequences of those decisions, are unknown. Additionally, linkages between wintering and breeding regions are generally unknown, and may influence within-winter movement rates. METHODS: We used Global Positioning System and acceleration data from 97 white-fronts during two winters to elucidate movement characteristics, model regional transition probabilities using a multistate model in a Bayesian framework, estimate regional energy expenditure, and determine behavior time-allocation influences on energy expenditure using overall dynamic body acceleration and linear mixed-effects models. We assess the linkages between wintering and breeding regions by evaluating the winter distributions for each breeding region. RESULTS: White-fronts exhibited greater daily movement early in the winter period, and decreased movements as winter progressed. Transition probabilities were greatest towards contemporary winter regions and away from historical wintering regions. Energy expenditure was up to 55% greater, and white-fronts spent more time feeding and flying, in contemporary wintering regions compared to historical regions. White-fronts subsequently summered across their entire previously known breeding distribution, indicating substantial mixing of individuals of varying breeding provenance during winter. CONCLUSIONS: White-fronts revealed extreme plasticity in their wintering strategy, including high immigration probability to contemporary wintering regions, high emigration from historical wintering regions, and high regional fidelity to western regions, but frequent movements among eastern regions. Given that movements of white-fronts trended toward contemporary wintering regions, we anticipate that a wintering distribution shift eastward will continue. Unexpectedly, greater energy expenditure in contemporary wintering regions revealed variable energetic consequences of choice in wintering region and shifting distribution. Because geese spent more time feeding in contemporary regions than historical regions, increased energy expenditure is likely balanced by increased energy acquisition in contemporary wintering areas.

Influenza A viruses remain infectious for more than seven months in northern wetlands of North America.

In this investigation, we used a combination of field- and laboratory-based approaches to assess if influenza A viruses (IAVs) shed by ducks could remain viable for extended periods in surface water within three wetland complexes of North America. In a field experiment, replicate filtered surface water samples inoculated with duck swabs were tested for IAVs upon collection and again after an overwintering period of approximately 6-7 months. Numerous IAVs were molecularly detected and isolated from these samples, including replicates maintained at wetland field sites in Alaska and Minnesota for 181-229 days. In a parallel laboratory experiment, we attempted to culture IAVs from filtered surface water samples inoculated with duck swabs from Minnesota each month during September 2018-April 2019 and found monthly declines in viral viability. In an experimental challenge study, we found that IAVs maintained in filtered surface water within wetlands of Alaska and Minnesota for 214 and 226 days, respectively, were infectious in a mallard model. Collectively, our results support surface waters of northern wetlands as a biologically important medium in which IAVs may be both transmitted and maintained, potentially serving as an environmental reservoir for infectious IAVs during the overwintering period of migratory birds.

Waterfowl occurrence and residence time as indicators of H5 and H7 avian influenza in North American Poultry.

Avian influenza (AI) affects wild aquatic birds and poses hazards to human health, food security, and wildlife conservation globally. Accordingly, there is a recognized need for new methods and tools to help quantify the dynamic interaction between wild bird hosts and commercial poultry. Using satellite-marked waterfowl, we applied Bayesian joint hierarchical modeling to concurrently model species distributions, residency times, migration timing, and disease occurrence probability under an integrated animal movement and disease distribution modeling framework. Our results indicate that migratory waterfowl are positively related to AI occurrence over North America such that as waterfowl occurrence probability or residence time increase at a given location, so too does the chance of a commercial poultry AI outbreak. Analyses also suggest that AI occurrence probability is greatest during our observed waterfowl northward migration, and less during the southward migration. Methodologically, we found that when modeling disparate facets of disease systems at the wildlife-agriculture interface, it is essential that multiscale spatial patterns be addressed to avoid mistakenly inferring a disease process or disease-environment relationship from a pattern evaluated at the improper spatial scale. The study offers important insights into migratory waterfowl ecology and AI disease dynamics that aid in better preparing for future outbreaks.

Influenza A Prevalence and Subtype Diversity in Migrating Teal Sampled Along the United States Gulf Coast.

Wild birds in the order Anseriformes are important reservoirs for influenza A viruses (IAVs); however, IAV prevalence and subtype diversity may vary by season, even at the same location. To better understand the ecology of IAV during waterfowl migration through the Gulf Coast of the United States (Louisiana and Texas), surveillance of blue-winged (Spatula discors) and American green-winged (Anas carolinensis) teal was conducted. The surveillance was done annually during the spring (live capture; 2012-17) and fall (hunter harvested; 2007-17) at times inferred to coincide with northward and southward movements, respectively, for these waterfowl species. During spring migration, 266 low pathogenicity (LP) IAV positive samples were recovered from 7547 paired cloacal-oropharyngeal (COP) samples (prevalence, 3.5%; annual range, 1.3%-8.4%). During fall migration, 650 LP IAV-positive samples were recovered from 9493 COP samples (prevalence, 6.8%; annual range, 0.4%-23.5%). Overall, 34 and 20 different IAV subtypes were recovered during fall and spring sampling, respectively. Consistent with previous results for fall migrating ducks, H3 and H4 hemagglutinin (HA) subtypes were most common; however, H4 subtype viruses predominated every year. This is in contrast to the predominance of LP H7 and H10 HA subtype viruses during spring. The N6 and N8 neuraminidase subtypes, which were usually associated with H4, were most common during fall; the N6 subtype was not recovered in the spring. These consistent seasonal trends in IAV subtype detection in teal are currently not understood and highlight the need for further research regarding potential drivers of spatiotemporal patterns of infection, such as population immunity.

Prevalencia del virus de la influenza A y diversidad de subtipos en cercetas migratorias muestreadas a lo largo de la costa del Golfo en los Estados Unidos. Las aves silvestres del orden Anseriformes son reservorios importantes para los virus de la influenza A; sin embargo, la prevalencia del virus de influenza aviar y la diversidad de subtipos puede variar según la temporada, incluso en el mismo lugar. Para comprender mejor la ecología del virus de la influenza aviar durante la migración de aves acuáticas a través de la Costa del Golfo en los Estados Unidos (Louisiana y Texas), se llevó a cabo el muestreo anual de cercetas de alas azules (Spatula discors) y de cercetas americanas (Anas carolinensis) tanto en primavera (capturadas vivas entre los años 2012-17) como en otoño (obtenidas por cazadores, entre los años 2007-17), periodos que se han inferido que a veces coinciden con los movimientos hacia el norte y hacia el sur, respectivamente, para estas especies de aves acuáticas. Durante la migración de primavera, se recuperaron 266 muestras positivas para influenza aviar de baja patogenicidad de 7547 muestras pareadas cloacales y orofaríngeas (prevalencia, 3.5%, rango anual de 1.3% a 8.4%). Durante la migración de otoño, se recuperaron 650 muestras positivas de 9493 muestras pareadas cloacales y orofaríngeas (prevalencia, 6.8%, rango anual, de 0.4% a 23.5%). En general, se recuperaron 34 y 20 subtipos diferentes de virus de la influenza aviar durante los muestreos de otoño y primavera, respectivamente. Consistente con los resultados anteriores para patos que migran en el otoño, los subtipos de hemoaglutinina H3 y H4 fueron los más comunes; sin embargo, los virus del subtipo H4 predominaron todos los años. Esto contrasta con la predominancia del subtipo H7 y H10 de baja patogenicidad durante la primavera. Los subtipos de neuraminidasa N6 y N8, que generalmente se asociaron con subtipos H4, fueron los más comunes durante el otoño; el subtipo N6 no se recuperó en la primavera. Estas tendencias estacionales constantes en la detección de subtipos del virus de influenza aviar en cercetas actualmente no se comprenden completamente y resaltan la necesidad de más investigación con respecto a los posibles factores determinates de los patrones espaciotemporales de infección, como la inmunidad de la población.

The Treatment of Autism Spectrum Disorder With Auditory Neurofeedback: A Randomized Placebo Controlled Trial Using the Mente Autism Device.

Introduction: Children affected by autism spectrum disorder (ASD) often have impairment of social interaction and demonstrate difficulty with emotional communication, display of posture and facial expression, with recognized relationships between postural control mechanisms and cognitive functions. Beside standard biomedical interventions and psychopharmacological treatments, there is increasing interest in the use of alternative non-invasive treatments such as neurofeedback (NFB) that could potentially modulate brain activity resulting in behavioral modification. Methods: Eighty-three ASD subjects were randomized to an Active group receiving NFB using the Mente device and a Control group using a Sham device. Both groups used the device each morning for 45 minutes over a 12 week home based trial without any other clinical interventions. Pre and Post standard ASD questionnaires, qEEG and posturography were used to measure the effectiveness of the treatment. Results: Thirty-four subjects (17 Active and 17 Control) completed the study. Statistically and substantively significant changes were found in several outcome measures for subjects that received the treatment. Similar changes were not detected in the Control group. Conclusions: Our results show that a short 12 week course of NFB using the Mente Autism device can lead to significant changes in brain activity (qEEG), sensorimotor behavior (posturography), and behavior (standardized questionnaires) in ASD children.

A population-based incidence of acute large vessel occlusions and thrombectomy eligible patients indicates significant potential for growth of endovascular stroke therapy in the USA.

BACKGROUND: Data on large vessel strokes are important for resource allocation and infrastructure development. OBJECTIVE: To determine an annual incidence of large vessel occlusions (LVOs) and a thrombectomy eligible patient population. METHODS: All patients with acute ischemic stroke discharged over 3 years from a tertiary-level hospital serving a large geographic area were evaluated for an LVO (M1, internal carotid artery terminus, basilar artery). The incidence of LVO was determined for the hospital's 4-county primary service area (PSA, population 210 000) based on each county's discharges and extrapolated to the US population. 'Thrombectomy eligibility' for anterior circulation LVOs was based on time (onset <6 hours) and imaging (Alberta Stroke Program Early CT Score (ASPECTS) ≥6). The number of annual thrombectomy procedures was calculated for Medicare and private payer patients using federally available databases. RESULTS: 1157 patients were discharged from the hospital's PSA, of whom 129 (11.1%, 95% CI 9.5% to 13.1%) had an LVO. This translated into an LVO incidence of 24 per 100 000 people per year (95% CI 20 to 28). 20 per 100 000 people per year had anterior circulation LVOs (95% CI 19 to 22), of whom 10/100 000/year (95% CI 8 to 11) were 'thrombectomy eligible'. An additional 5/100 000/year (95% CI 3 to 6) presented with favorable ASPECTS after 6 hours of symptom onset. Basilar occlusion incidence was estimated at 4/100 000/year (95% CI 2 to 5). These rates yield 77 569 (95% CI 65 835 to 91 091) new LVOs per year in the USA. An estimated 10 284 mechanical thrombectomy procedures were performed in 2015. CONCLUSIONS: This study estimates an LVO incidence of 24 per 100 000 person-years (95% CI 20 to 28). A current estimated annual thrombectomy rate of three procedures per 100 000 people indicates significant potential increase in the volume of endovascular procedures and the need to develop systems of care.

Evidence for wild waterfowl origin of H7N3 influenza A virus detected in captive-reared New Jersey pheasants.

In August 2014, a low-pathogenic H7N3 influenza A virus was isolated from pheasants at a New Jersey gamebird farm and hunting preserve. In this study, we use phylogenetic analyses and calculations of genetic similarity to gain inference into the genetic ancestry of this virus and to identify potential routes of transmission. Results of maximum-likelihood (ML) and maximum-clade-credibility (MCC) phylogenetic analyses provide evidence that A/pheasant/New Jersey/26996-2/2014 (H7N3) had closely related H7 hemagglutinin (HA) and N3 neuraminidase (NA) gene segments as compared to influenza A viruses circulating among wild waterfowl in the central and eastern USA. The estimated time of the most recent common ancestry (TMRCA) between the pheasant virus and those most closely related from wild waterfowl was early 2013 for both the H7 HA and N3 NA gene segments. None of the viruses from waterfowl identified as being most closely related to A/pheasant/New Jersey/26996-2/2014 at the HA and NA gene segments in ML and MCC phylogenetic analyses shared ≥99 % nucleotide sequence identity for internal gene segment sequences. This result indicates that specific viral strains identified in this study as being closely related to the HA and NA gene segments of A/pheasant/New Jersey/26996-2/2014 were not the direct predecessors of the etiological agent identified during the New Jersey outbreak. However, the recent common ancestry of the H7 and N3 gene segments of waterfowl-origin viruses and the virus isolated from pheasants suggests that viral diversity maintained in wild waterfowl likely played an important role in the emergence of A/pheasant/New Jersey/26996-2/2014.

Evidence for the exchange of blood parasites between North America and the Neotropics in blue-winged teal (Anas discors).

Blue-winged teal (Anas discors) are abundant, small-bodied dabbling ducks that breed throughout the prairies of the northcentral USA and central Canada and that winter in the southern USA and northern Neotropics. Given the migratory tendencies of this species, it is plausible that blue-winged teal may disperse avian pathogens, such as parasites causing avian malaria, between spatially distant areas. To test the hypothesis that blue-winged teal play a role in the exchange of blood parasites between North America and areas further south, we collected information on migratory tendencies of this species and sampled birds at spatially distant areas during breeding and non-breeding periods to diagnose and genetically characterize parasitic infections. Using a combination of band recovery data, satellite telemetry, molecular diagnostics, and genetic analyses, we found evidence for (1) migratory connectivity of blue-winged teal between our sampling locations in the Canadian prairies and along the US Gulf Coast with areas throughout the northern Neotropics, (2) parasite acquisition at both breeding and non-breeding areas, (3) infection of blue-winged teal sampled in Canada and the USA with Plasmodium parasite lineages associated with the Neotropics, and (4) infection of blue-winged teal with parasites that were genetically related to those previously reported in waterfowl in both North America and South America. Collectively, our results suggest that blue-winged teal likely play a role in the dispersal of blood parasites between the Neotropics and North America, and therefore, the targeting of this species in surveillance programs for the early detection of Neotropical-origin avian pathogens in the USA may be informative.

Evidence for seasonal patterns in the relative abundance of avian influenza virus subtypes in blue-winged teal (Anas discors).

Seasonal dynamics of influenza A viruses (IAVs) are driven by host density and population immunity. Through an analysis of subtypic data for IAVs isolated from Blue-winged Teal (Anas discors), we present evidence for seasonal patterns in the relative abundance of viral subtypes in spring and summer/autumn.